Pain management communication between parents and nurses after pediatric outpatient surgery.

PURPOSE: The purpose of this study was to explore parent-nurse pain management communication during a child's discharge process following pediatric outpatient surgery. DESIGN AND METHODS: Thirty-two clinical encounters at discharge between parents (N = 40) and nurses (N = 25) at BC Children's Hospital were audio recorded and transcribed verbatim. Content analysis was applied on the audio recordings and corresponding transcripts using MAXQDA qualitative research software and Microsoft Excel. RESULTS: Overall, nurses delivered pain management instructions at an average sixth grade readability level and frequently used communication elements of reassurance, optimism, and question-asking. Less consistent communication elements included open-ended questions, interruptions, and promotion of parental decision-making. Parents most frequently asked one to five questions, with pain medication being the most inquired topic. CONCLUSIONS: Several strengths of the nurse communication approach were identified, and parent questions highlighted a need for greater understanding around pain medication. PRACTICE IMPLICATIONS: These findings will help guide effective pain management communication and care for young patients and their families.

Barriers and Facilitators to Effective Pain Management by Parents After Pediatric Outpatient Surgery.

INTRODUCTION: The purpose of this study was to describe the experience of postoperative pain management from the perspectives of parents and identify areas for improvement. METHOD: Forty parents or legal guardians of children aged 5-18 years who underwent outpatient surgery at BC Children's Hospital were recruited. Qualitative semistructured interviews were conducted to explore participants' experiences with the discharge instructions and at-home pain management. RESULTS: Overall, participants reported positive experiences with pain management. Facilitators in pain management communication included the combination of verbal and written instructions. Barriers to effective pain management included discrepancies in the information provided by different health care professionals and the experience of stress at the time of pain management communication. DISCUSSION: The exploration of parent narratives highlighted the need for detailed information resources and patient-centered care surrounding pain management. The practical recommendations identified will inform future research and improve the quality of care for pediatric pain.

Improving the paediatric surgery patient experience: an 8-year analysis of narrative quality data.

BACKGROUND: Narrative data about the patient experience of surgery can help healthcare professionals and administrators better understand the needs of patients and their families as well as provide a foundation for improvement of procedures, processes and services. However, units often lack a methodological framework to analyse these data empirically and derive key areas for improvement. The American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) is aimed at improving the quality of surgical care by collecting patient data and reporting risk-adjusted surgical outcomes for each participant hospital in the programme. Though qualitative data about patient experience are captured as part of the NSQIP database, to date no framework or methodology has been proposed, or reported on, to analyse these data for the purposes of quality improvement. The goal of this study was to demonstrate the feasibility of using content analysis to empirically derive key areas for quality improvement from a sample of 3601 narrative comments about paediatric surgery from patients and families at British Columbia Children's Hospital. STUDY DESIGN: Thematic content analysis conducted on a total of 3601 patient and family narratives received between 2011 and 2018. RESULTS: Overall satisfaction with care was high and experiences with healthcare providers at the hospital were positive. Areas for improvement were identified in the themes of health outcomes, communication and surgery timelines. Results informed follow-up interprofessional quality improvement initiatives. CONCLUSIONS: Recording and analysing patient experience data as part of validated quality improvement programmes such as ACS NSQIP can provide valuable and actionable information to improve quality of care.